Identification and characterization of areas of extended perinatal mortality rates associated with congenital anomalies, Colombia 1999-2008

Author (s): 
Claudia Patricia Roncancio Melgarejo, Sandra Patricia Misnaza Castrillón and Isabel Cristina Peña Eraso

Objectives:

  • Determine the characteristics of fetal, perinatal, and extended perinatal mortality caused by congenital anomalies between 1999 and 2008 using vital statistics
  • Detect areas with high mortality rates and mortality concentration of congenital anomalies

Methodology:

  • Descriptive Study
  • Mortality vital statistic registries

Discussion:

  • The geographical distribution of the extended Perinatal mortality by central nervous system anomalies remains despite a folic acid supplementation program (2002).
  • Mortality by chromosomal anomalies showed an increasing trend since 2003.
  • Cardiovascular system anomalies show an increasing trend during the all period.
  • Geographical mortality areas: Show a belt pattern of municipalities between departments: Andina and Orinoquia regions (eastern plains); Areas with important agricultural production; Areas are related to geographical location of river sources, Cauca, Magdalena and Guaviare river

Conclusions:

  • Perinatal mortality analysis based on vital statistics helps us to understand the characteristics of mortality associated with congenital anomalies.
  • Geographical areas could identify specific for implementation or strengthen of public actions, in order to reduce its occurrence.
  • Geographical analysis of municipalities by anomalies group invite to more specific factorial analysis studies and propose more precise intervention.

Recommendations:

  • Improve the registry of fetal and neonatal deaths around the country in urban and rural zones.
  • Design specific prevention strategies for birth defects. For example, enforcement of folic acid supplementation initiatives in areas with the highest number of cases of neural tube defects.
  • Investment in high mortality areas in order to find related environmental factors and developing intervention plans in all levels.
  • Cardiovascular system anomalies findings supports antenatal screening and multidisciplinary care to improve survival in preventable cases.
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